Check the completed osteosynthesis with image intensification. These images should be retained for documentation or alternatively an x-ray should be obtained before discharge.
Make sure that the plate is at the correct location, the screws and the nail are of appropriate length and the desired reduction has been achieved.
Stabilize the elbow at the epicondyles and check the forearm rotation.
7. Aftercare following plating
Immediate postoperative care
Whilst the child remains in bed, the forearm should be elevated on pillows to reduce swelling and pain.
Casting or Splinting
Plate fixation of forearm fractures is intrinsically stable and supplementary casting or splinting is therefore not required.
Some surgeons prefer a long or short splint for 2-3 weeks postoperatively for comfort.
Ibuprofen and paracetamol should be administered regularly during the first 4-5 days of injury, with additional oral narcotic medication for breakthrough pain.
If the level of pain is increasing the child should be examined.
The child should be examined regularly, to ensure finger range of motion is comfortable and adequate.
Neurological and vascular examination should also be performed.
Compartment syndrome should be considered in the presence of increasing pain, especially pain on passive stretching of muscles, decreasing range of active finger motion or deteriorating neurovascular signs, which are a late phenomenon.